Appointment Request Form

Request Appointment at Mecklenburg Eye Associates
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Mecklenburg Eye Associates is a provider for Medicare, most major insurance plans, and several routine eye plans including EyeMed, VSP, Superior, VCP and Community Eyecare. We provide insurance billing. Anything not covered by insurance will be your responsibility. We request payment at the time of your appointment for services that are not covered by insurance. Your insurance company may also require you to pay a co-payment at the time of your appointment. When necessary, our staff will work closely with patients who require a payment plan. If you have any questions regarding which insurance plans we accept or any billing concerns, please call us at the phone number below. Questions regarding your coverage and benefits should be directed to your employer or insurance company

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Communications with our office via this website are not intended to replace an office visit. Please do not include any personal health information when completing this form. This form should be used only for routine and non-urgent matters. If you are experiencing a medical emergency, please call 911 or go to your nearest hospital emergency room.